Opposite effect of inflammation on subventricular zone versus hippocampal precursors in brain injury.

Objective: Inflammation promotes epidermal wound healing but is considered detrimental to recovery from central nervous system injury. Sick infants have increased levels of cytokines in their cerebrospinal fluid that correlate with poor neurological outcome. In this study, we investigated the role of neuroinflammation and more specifically interleukin 6 (IL-6) in the amplification of subventricular zone (SVZ) and subgranular zone (SGZ) neural precursors after neonatal brain injury.

Is the diagnosis of atypical glandular cells of undetermined significance associated with greater risk at an inner city hospital?

Objective: To test the hypothesis that the high-risk patients at an inner city hospital with atypical glandular cells of undetermined significance (AGC) on their Pap smears have a higher rate of underlying significant pathology than that reported in published data.

Study Design: This was an Institutional Review Board-approved retrospective review of all AGC Pap smears performed at University Hospital, Newark, New Jersey, between January 1, 2001, and July 30, 2008. We defined significant pathology as cervical intraepithelial neoplasia 2 (CIN 2) or greater, endocervical adenocarcinoma in situ or greater, or simple hyperplasia or greater of the endometrium.

Cholinergic regulatory lymphocytes re-establish neuromodulation of innate immune responses in sepsis.

Many anti-inflammatory strategies that are successful in treating sepsis in healthy animals fail in clinical trials, in part because sepsis normally involves immunocompromised patients, and massive lymphocyte apoptosis prevents immunomodulation. In this article, we report a new set of regulatory lymphocytes that are able to re-establish the cholinergic anti-inflammatory modulation and to provide therapeutic advantages in sepsis. The vagus nerve controls inflammation in healthy, but not in septic, mice.

Vitamin D and intestinal calcium absorption.

The principal function of vitamin D in calcium homeostasis is to increase calcium absorption from the intestine. Calcium is absorbed by both an active transcellular pathway, which is energy dependent, and by a passive paracellular pathway through tight junctions. 1,25Dihydroxyvitamin D(3) (1,25(OH)(2)D(3)) the hormonally active form of vitamin D, through its genomic actions, is the major stimulator of active intestinal calcium absorption which involves calcium influx, translocation of calcium through the interior of the enterocyte and basolateral extrusion of calcium by the intestinal plasma membrane pump.

Recurrent knee pain in an athletic adult: multiple schwannomas secondary to schwannomatosis: a case report.

Schwannomatosis has been used to describe patients with multiple nonvestibular schwannomas with no associated features of neurofibromatosis type 2. In our case, a 28-year-old athletic man underwent a right knee excisional biopsy for multifocal, benign schwannomatosis. After being asymptomatic for 4 years postresection, he returned to our musculoskeletal oncology service.

Dedifferentiated liposarcoma of thigh with chondrosarcomatous dedifferentiated component.

Liposarcomas are common soft-issue sarcomas arising predominantly in deep soft tissue and the retroperitoneum with varied mortality and recurrence rates, largely dependent on histologic type. Thought to arise de novo, liposarcomas typically are classified into 5 types based on strict morphologic characteristics: well-differentiated, dedifferentiated, myxoid, round cell, and pleomorphic. More specifically, dedifferentiated liposarcoma, a common type most prevalent in the retroperitoneum, often has 2 distinct components, a well-differentiated lipomatous component and a dedifferentiated nonlipomatous component composed of sarcomas, such as myxofibrosarcomas or other spindle-cell sarcomas.

Commentary: More implications of the 2008 amendments to the Americans with Disabilities Act: influencing institutional policies, practices, and procedures.

The Americans with Disabilities Act (ADA) is a civil rights law designed to ensure that qualified individuals with disabilities are not discriminated against by covered entities. Under the ADA, colleges of medicine were expected to focus their attention on implementing policies that facilitated equal educational opportunity, not on the threshold question of whether an individual was considered "disabled enough" to be protected by the law. In this issue, Allen and Smith examine the implications of the 2008 ADA Amendments Act (ADAAA) for medical education, focusing on the potential for the ADAAA to eliminate the threshold question and allow individuals seeking protection to bring their cases to trial.

Clinical consequences of MRI activity in treated multiple sclerosis.

Background: Inflammation on brain MRI is the most sensitive marker of disease activity in multiple sclerosis (MS) but its clinical consequences remain controversial.

Objective: Here we investigated the clinical consequences of MRI activity in MS subjects treated with two different first line disease modifying agents.

Methods: Seventy-five treatment-naïve subjects with relapsing-remitting MS (N = 61) or clinically isolated syndromes at risk of MS (N = 14) from the BECOME study that had been randomized to interferon beta-1b (N = 39) or glatiramer acetate (N = 36) and followed for up to two years by monthly brain MRI optimized to detect inflammatory activity were studied for the clinical consequences of lack of MRI remission.

Malignant female adnexal tumor of probable Wolffian origin: a case report.

Background: Female adnexal tumor of probable Wolffian origin (FATWO) is a rare tumor arising in locations with Wolffian remnants, such as the broad ligament. It is thought to be a benign lesion, although this is not always the case, with scattered case reports of more aggressive behavior, sometimes years later.

Case: A rare case of disseminated malignant FATWO is presented and the literature reviewed.

Body mass index of patients with endometrial hyperplasia: comparison to patients with proliferative endometrium and abnormal bleeding.

Objective: Endometrial hyperplasia is a known risk factor for the development of endometrial cancer, particularly atypical hyperplasia, with a subsequent risk of up to 30%. Of the known risk factors for endometrial hyperplasia, obesity is the most preventable, but there is a paucity of data addressing the association. We tested the hypothesis that patients with endometrial hyperplasia have a higher body mass index (BMI) than patients with abnormal bleeding who are found to have proliferative endometrium.

Role of plasma membrane calcium ATPase 2 in spinal cord pathology.

A number of studies have indicated that plasma membrane calcium ATPases (PMCAs) are expressed in the brain and spinal cord and could play important roles not only in the maintenance of cellular calcium homeostasis but also in the survival and function of central nervous system cells under pathological conditions. The different regional and cellular distributions of the various PMCA isoforms and splice variants in the nervous system and the diverse phenotypes of PMCA knockout mice support the notion that each isoform might play a distinct role. Especially in the spinal cord, the survival of neurons and, in particular, motor neurons could be dependent on PMCA2.

Incomplete deployment of the Vena Tech LP filter--case series and concerns.

The Vena Tech LP vena cava filter (B Braun, Evanston, Illinois) has been FDA approved since 2001 and is a permanent vena cava filtration device. It replaced the previous Vena tech LGM filter also manufactured by B Braun. The LGM filter had 2 case series reporting a high incidence of incomplete deployment of the filter, especially when placed from a jugular approach.

Mesenchymal lesions of the vulva.

Mesenchymal lesions of the vulva may be either regionally specific to the vulva or soft tissue neoplasms that can occur in multiple locations on the body. They may have overlapping histological and immunohistochemical features and, in routine practice, are not likely to be encountered, adding to the diagnostic difficulty. A review of mesenchymal vulvar lesions is presented.

Analysis of cerebrospinal fluid from chronic fatigue syndrome patients for multiple human ubiquitous viruses and xenotropic murine leukemia-related virus.

Recent reports showed many patients with chronic fatigue syndrome (CFS) harbor a retrovirus, xenotropic murine leukemia-related virus (XMRV), in blood; other studies could not replicate this finding. A useful next step would be to examine cerebrospinal fluid, because in some patients CFS is thought to be a brain disorder. Finding a microbe in the central nervous system would have greater significance than in blood because of the integrity of the blood-brain barrier.

Dopaminergic neuronal differentiation protocol for human mesenchymal stem cells.

The generation of dopamine (DA) neurons from stem cells holds great promise for future biomedical research and in the clinical treatment of neurodegenerative diseases, such as Parkinson's disease. Mesenchymal stem cells (MSCs) derived from the adult human bone marrow (BM) can be easily isolated and expanded in culture while maintaining their immense plasticity. Here, we describe a protocol to generate DA-producing cells from adult human MSCs using a cocktail that includes sonic hedgehog (SHH), fibroblast growth factor 8 (FGF8), and basic fibroblast growth factor (bFGF).

Activation of protein kinase Tel1 through recognition of protein-bound DNA ends.

Double-strand breaks (DSBs) in chromosomal DNA elicit a rapid signaling response through the ATM protein kinase. ATM corresponds to Tel1 in budding yeast. Here we show that the catalytic activity of Tel1 is altered by protein binding at DNA ends via the Mre11-Rad50-Xrs2 (MRX) complex.

Distinct cerebrospinal fluid proteomes differentiate post-treatment lyme disease from chronic fatigue syndrome.

Background: Neurologic Post Treatment Lyme disease (nPTLS) and Chronic Fatigue (CFS) are syndromes of unknown etiology. They share features of fatigue and cognitive dysfunction, making it difficult to differentiate them. Unresolved is whether nPTLS is a subset of CFS.

Prenatal diagnosis of bilateral dacryocystocele using 3-D/4-D ultrasound technology: a case report.

Background: Bilateral dacryocystoceles develop as a result of obstruction of the nasolacrimal canal. The advances in obstetric sonography have led to increased diagnosis of this structural defect in the antenatal period as early as 24 weeks' gestation.

Case: We describe a case of bilateral dacryocystocele with clear visualization of this defect using 3-D/4-D sonography.

The STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) trial improves outcomes.

Objectives: The goal of this study was to evaluate the impact of the STAT-MI (ST-Segment Analysis Using Wireless Technology in Acute Myocardial Infarction) network on outcomes in the treatment of patients presenting with ST-segment elevation myocardial infarction (STEMI).

Background: Shortening door-to-balloon (D2B) time remains a national priority for the treatment of STEMI. We previously reported a fully automated wireless network (STAT-MI) for transmission of electrocardiograms (ECGs) for suspected STEMI from the field to offsite cardiologists, allowing early triage with shortening of subsequent D2B times.

Phenotypic and genotypic screening and clonal analysis of carbapenem-resistant Klebsiella pneumoniae at a single hospital.

Detection of bla(KPC)-harboring Klebsiella pneumoniae (KP) in the clinical laboratory remains a difficult task. Decreased ertapenem (ERT) susceptibility has been considered one of the most sensitive phenotypic indicators of K. pneumoniae carbapenemase (KPC) production, but has been found to be nonspecific.

Stackable carbon fiber cages for thoracolumbar interbody fusion after corpectomy: long-term outcome analysis.

Background: Reconstruction of the thoracolumbar spine after corpectomy is a challenge for fractures, infections, and tumors.

Objective: To analyze fusion rates, clinical outcomes, and the percent of vertebral body coverage achieved by using stackable carbon fiber-reinforced polyetheretherketone cages in thoracolumbar corpectomies, and to measure the actual size of the cages and compare this measurement with the size of the vertebra(e) replaced by the cage.

Methods: A retrospective study of 40 patients who underwent thoracolumbar corpectomies was performed.

Thymopharyngeal duct cyst: a case presentation and literature review.

The differential diagnosis of a lateral cystic neck mass includes branchial cleft cysts and lymphangiomas. Cervical thymic cysts are rare, and thymopharyngeal duct cysts, which maintain a connection to the pharynx, are rarer still. We present an interesting case of a 6 year-old male who developed acute onset of a left-sided neck mass.

Recurrent hypertrophy of the labia minora: a hormonally related lesion possibly related to fibroepithelial stromal polyps of the vulva.

The literature on hypertrophy of the labia minora has focused predominantly on surgical procedures, with little attention to etiology. We present a case of recurrent labial hypertrophy and postulate that this is a hormonally related lesion, similar to fibroepithelial stromal polyps.